Randomized clinical trials and meta-analyses describe the benefit of chemotherapy and combined chemotherapy and radiotherapy for specific subgroups of brain tumour patients with selected patient and disease characteristics. This study estimates the overall survival benefit for the population of adult primary malignant brain tumour patients in Australia if evidence-based guidelines for chemotherapy were followed.
An evidence-based model describing the total proportion of brain tumour that would benefit from chemotherapy has been previously reported . Multiple electronic citation databases were systematically queried, including Medline and the Cochrane Library. All malignant brain tumour categories were included in the analysis. Additional branches were added in cases where new sub-groups benefit from chemotherapy. For all defined indications, the highest level of clinical evidence available was identified, and the 1- and 5–year survival benefits used in the tree. In cases where there were multiple sources of the same level of evidence, hierarchical meta-analysis was performed. The overall benefit of chemotherapy was estimated for 1- and 5-year survival. The robustness of the estimates was tested by Monte Carlo simulation multivariate analysis.
The estimated 1-year and 5-year absolute population-based overall survival benefits of optimally utilized first-line chemotherapy for adult primary malignant brain tumour in Australia are 7.6% (95% Confidence Interval CI 6.9%-8.2%), and 4.2% (95% CI 3.7%-4.6%), respectively. The estimated 1-year and 5-year survival benefits for Glioblastoma Multiforme patients are 15.8% and 7.4%, compared to 3.6% and 9.5% survival gains for patients with Anaplastic Astrocytoma.
The 1-year and 5-year survival benefits for first-line chemotherapy for brain tumour patients have been estimated to be 7.6% and 4.2% respectively.
Clinical trial identification
All authors have declared no conflicts of interest.
 Jacob, S., et al., Estimation of an optimal chemotherapy utilisation rate for primary malignant brain tumours: an evidence-based benchmark for cancer care. Clin Oncol (R Coll Radiol), 2011. 23(1): p. 48–54.